New data published today by the UK Health Security Agency (UKHSA) show a large reduction in the number of people living with chronic hepatitis C (HCV) infection in England. The report has found that the number of people aged over 16 in England living with chronic HCV has declined by 51.6% since 2015, from an estimated 129,400 to 62,600 in 2022.
The decline in people living with the virus is largely due to improved testing and access to treatment. Substantial developments have been made to increase the numbers of individuals being tested for hepatitis C, including through NHS England’s opt-out testing programme in Emergency Departments and an increase in people accessing antivirals. Since these effective drugs became available in 2015, NHS England data indicate that 77,862 people have begun treatment. These effective treatments have also helped to reduce HCV-related mortality, with deaths due to the virus at their lowest in ten years (0.44 deaths per 100,000 population in 2022, compared to 0.69 per 100,000 in 2015).
HCV is a is a bloodborne virus that can cause life-threatening liver disease, including cancer. However, those infected often have no symptoms until many years later when their liver has been badly damaged. When symptoms do occur, they can often be non-specific, like tiredness or loss of appetite, and be dismissed or mistaken for other conditions.
The virus is spread through blood-to-blood contact, most commonly in the UK by sharing needles contaminated with the virus. Other people at risk of acquiring the infection are those who have been in prison, have experienced homelessness, have had a medical procedure or tattoo abroad, are from a country with a higher prevalence of HCV, or received a blood transfusion before 1991.
Based on modelled estimates, 62,600 people were estimated to be living with HCV in 2022. Of them:
- 20.1% of infections are estimated to be in people who are who are currently or have recently (past 3 years) injected drugs
- 64.5% are in those who have previously injected drugs but are no longer injecting.
There are an estimated 9,600 people with chronic HCV infection who have never injected drugs.
In order to help find the remaining cases, in May 2023, NHS England launched a website where people can order at home self-testing kits. More than 16,000 testing kits have now been ordered from hepctest.nhs.uk, helping to identify more cases of hepatitis C and start people on treatment sooner.
Rachel Halford, CEO of The Hepatitis C Trust, said:
“The progress towards eliminating hepatitis C in this country is nothing short of astounding. Investment in initiatives that meet people where they are and link them up with health services has been a very successful way of reducing the number of people living with the virus. The success of this progress has been thanks to incredible multi-stakeholder partnership work that has kept people with lived experience at the centre. Peer support provided by people who have experience of hepatitis C has been proven vital and supported thousands of people to get educated, tested and treated.
“Moving forward we need to develop a national strategy which will ensure we reach elimination and maintain this over the long term. This will require clear goals, strong disease surveillance, and a balanced approach to tackling the virus.”